@article{ref1,
title="Seeing the signs: using the course of residual depressive symptomatology to predict patterns of relapse and recurrence of major depressive disorder",
journal="Depression and anxiety",
year="2018",
author="Verhoeven, Floor E. A. and Wardenaar, Klaas J. and Ruhé, Henricus G. Eric and Conradi, Henk-Jan and de Jonge, Peter",
volume="35",
number="2",
pages="148-159",
abstract="BACKGROUND: Major depressive disorder (MDD) is characterized by high relapse/recurrence rates. Predicting individual patients' relapse/recurrence risk has proven hard, possibly due to course heterogeneity among patients. This study aimed to (1) identify homogeneous data-driven subgroups with different patterns of relapse/recurrence and (2) identify associated predictors. <br><br>METHODS: For a year, we collected weekly depressive symptom ratings in 213 primary care MDD patients. Latent class growth analyses (LCGA), based on symptom-severity during the 24 weeks after no longer fulfilling criteria for the initial major depressive episode (MDE), were used to identify groups with different patterns of relapse/recurrence. Associations of baseline predictors with these groups were investigated, as were the groups' associations with 3- and 11-year follow-up depression outcomes. <br><br>RESULTS: LCGA showed that heterogeneity in relapse/recurrence after no longer fulfilling criteria for the initial MDE was best described by four classes: &quot;quick symptom decline&quot; (14.0%), &quot;slow symptom decline&quot; (23.3%), &quot;steady residual symptoms&quot; (38.7%), and &quot;high residual symptoms&quot; (24.1%). The latter two classes showed lower self-esteem at baseline, and more recurrences and higher severity at 3-year follow-up than the first two classes. Moreover, the high residual symptom class scored higher on neuroticism and lower on extraversion and self-esteem at baseline. Interestingly, the steady residual symptoms and high residual symptoms classes still showed higher severity of depressive symptoms after 11 years. <br><br>CONCLUSION: Some measures were associated with specific patterns of relapse/recurrence. Moreover, the data-driven relapse/recurrence groups were predictive of long-term outcomes, suggesting that patterns of residual symptoms could be of prognostic value in clinical practice.<br><br>© 2017 Wiley Periodicals, Inc.<p /> <p>Language: en</p>",
language="en",
issn="1091-4269",
doi="10.1002/da.22695",
url="http://dx.doi.org/10.1002/da.22695"
}